Abstract Background Petrous cholesteatoma is an entity of significant clinical ramifications especially concerning surgical risks it poses due to close proximity with vital skull-base neurovascular structures. Despite the challenges, surgical extirpation is still the treatment of choice. Conventional methods comprise external trans-mastoid routes through trans-labyrinth, retro-sigmoid and middle cranial fossa.Case presentation In this paper, we present a man native to Borneo, having previously been surgically treated for cholesteatoma who presented with a recurrence at the petrous apex. It was excised entirely via endoscopic trans-canal supra-labyrinth approach.Conclusion Endoscopic removal is currently gaining favor amongst skull-base surgeons as more complex cases has been dealt successfully and reported worldwide. Nonetheless it is an intricate procedure that requires a highly skilled and confident operator which demands experience.
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Roy et al. (2024) studied this question.
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